Page 1 ? Key Words Geschwind epilepsy, anterograde amnesia ...



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‫ࡓ࠙ࠫࡐࡦࠪع‬㧦⸥ᙘ㓚ኂ߳ߩᣂߚߥࠕࡊࡠ࡯࠴

ߡࠎ߆ࠎᕈஜᔓ ✛ Ꮉ   ᥏㧖㧖㧖㧖㧖㧖ศ ᧛ ⩿Ⓞሶ㧖㧖 ᴡ ᧛   ḩ㧖㧖㧘㧖㧖㧖 ⷐᣦ㧦⸥㌏ജᬌᩏߩᚑ❣߇⦟ᅢߢ޽ࠆߦ߽߆߆ࠊࠄߕᄙ᭽ߥஜᔓ∝⁁ࠍ๒ߒߚ஥㗡⪲ߡࠎ߆ࠎ∝଀ ࠍᬌ⸛ߒߚ‫⊒ࠎ߆ࠎߡޕ‬૞ߩ․ᓽߪ㧘ⶄ㔀ㇱಽ⊒૞ߣᢙᤨ㑆ߩㅒะᕈஜᔓࠍ઻ߞߚஜᔓ⊒૞ߢ޽ߞ ߚ‫ޕ‬೨ะᕈஜᔓߪ㧘ᢙᣣන૏ߢߪ᣿ࠄ߆ߢߪߥߊ㧘߅ࠃߘ  ㅳ㑆ߩ㑆㓒ࠍ޽ߌࠆߎߣߦࠃߞߡೋ߼ ߡ㗼࿷ൻߔࠆ߽ߩߢ޽ߞߚ‫ޕ‬ㅒะᕈஜᔓߪ⥄વ⊛⸥ᙘࠍਛᔃߣߔࠆ  ᐕએ਄ߦࠊߚࠆ㓚ኂߢ޽ߞ ߚ‫⊒ࠎ߆ࠎߡࠇߙࠇߘߪࠄࠇߎޕ‬૞ߦࠃߞߡ↢ߓߚ㐳ᦼ⸥ᙘߩ࿕ቯൻߩ㓚ኂߣ㧘⊹⾰ߦ޽ࠆ⸥ᙘ∥ 〔ߩᶖᄬߣ⠨߃ࠄࠇߚ‫ޕ‬᛫ߡࠎ߆ࠎ⮎ߩ᦯↪ߦࠃࠅ㧘೨ะᕈஜᔓߪ⪺ߒ޿ᡷༀࠍ⹺߼ߚ߇㧘ㅒะᕈ ஜᔓߪ᣿ࠄ߆ߥᡷༀ߇⹺߼ࠄࠇߥ߆ߞߚ‫ࠄ߆ߣߎߩߎޕ‬㧘ㅒะᕈஜᔓ߇㕖นㅒ⊛ߥㆊ⒟ߢ↢ߓߡ޿ ࠆߣ⠨߃ࠄࠇߚ‫⊒ࠎ߆ࠎߡޕ‬૞ߦ⿠࿃ߔࠆ⥃ᐥ∛ᘒߩᬌ⸛߇㧘ੱ㑆߇ᜬߟ⸥ᙘߩ৻஥㕙ࠍ᣿ࠄ߆ߦ ߔࠆߣᕁࠊࠇࠆ‫                 ޕ‬㧔㜞ᰴ⣖ᯏ⢻⎇ⓥ  㧦㨪 Key Words ߡࠎ߆ࠎ⊒૞㧘೨ะᕈஜᔓ㧘ㅒะᕈஜᔓ㧘࿕ቯൻGeschwind∝୥⟲        epilepsy, anterograde amnesia㧘retrograde amnesia, consolidation,        Geschwind syndrome 

ߪߓ߼ߦ   ߡࠎ߆ࠎߣஜᔓߣߩ㑐ଥߪฎߊߡᣂߒ޿߽ߩߢ ޽ࠆ‫ ޕ‬ᐕએ਄߽೨߆ࠄߔߢߦߡࠎ߆ࠎߣ⸥ᙘ 㓚ኂߩ㑐ㅪ߇ㅀߴࠄࠇߡ޿ࠆ߇ Hughlings Jacksonߎࠇ߹ߢߩ̌ߡࠎ߆ࠎ̍߿ ̌⸥ᙘ㓚ኂ̍ߩ࠹ࠠࠬ࠻ߦߪ㧘ߘࠇࠄߩ㑐ଥߦߟ ޿ߡߩ⸥タߪߌߞߒߡᄙߊߪߥ޿‫ߩߘޕ‬ਛߢ߽ ߽ߞ߬ࠄߩ㑐ᔃߪ㧘᛫ߌ޿ࠇࠎ⮎߇⸥ᙘߦ߽ߚࠄ ߔᓇ㗀߿㧘ಾ㒰ㇱ૏ߣ⸥ᙘ㓚ኂߣߩ㑐ㅪߥߤߦ޽ ߡࠄࠇߡ߅ࠅ㧘⊒૞ߘߩ߽ߩߩᓇ㗀ߦ㑐ߒߡߪ⷗ ㆊߏߐࠇߡ߈ߚㇱಽ߇ᄙ޿‫ߒ߆ߒޕ‬ㄭᐕ㧘ߡࠎ߆ ࠎ⊒૞ߦ⿠࿃ߔࠆ⸥ᙘ㓚ኂߦߟ޿ߡ޿ߊߟ߆ߩ✚ ⺑߇಴ߐࠇ㧔ߚߣ߃߫ Zeman ࠄ ⥃ᐥ⊛ ․ᓽ߇ᢛℂߐࠇߟߟ޽ࠅ Kapur ࠄ 㧕㧘⸥ ᙘ⎇ⓥߩ㗔ၞ߆ࠄ߽㧘ߡࠎ߆ࠎࠍኻ⽎ߣߒߚ⎇ⓥ ߇⷗⋥ߐࠇߟߟ޽ࠆࠃ߁ߢ޽ࠆ‫ޕ‬  ᧄ⺰ߢߪ㧘ᄙ᭽ߥஜᔓ∝⁁ࠍ๒ߒߚ∝଀ࠍ␜ߔ

ߣߣ߽ߦ㧘ߡࠎ߆ࠎ⊒૞ߩⷰὐ߆ࠄߘߩᯏᐨߦߟ ޿ߡ⠨ኤߔࠆ‫ޕ‬         㧵㧚∝  ଀

  ∝଀ߪ  ᱦ㧘ฝ೑߈ߩᅚᕈ‫ޕ‬㜞╬ቇᩞතᬺᓟ㧘 มᦠߣߒߡ౏┙࿑ᦠ㙚ߦൕോߒߡ޿ࠆ‫ߴߔ⸥․ޕ‬ ߈ᣢᓔᱧߪߥ޿‫ޕ‬  ⃻∛ᱧ㧦 ᐕߏࠈࠃࠅᕈᩰᄌൻ㧔㗎࿕ߦ ߥߞߚ㧕߿ਥⷐߥ಴᧪੐ࠍᙘ߃ߡ޿ߥ޿ߎߣߢኅ ᣖ߇⇣Ᏹߦ᳇ߠ߈ᆎ߼ߚ‫ ޕ‬ᐕ  ᦬ߩᧄੱߩ ᚻᏭߦߪߔߢߦ⊒૞ߩ೨ళࠍ␜ໂߔࠆ⸥ㅀ߇⹺߼ ࠄࠇߚ‫ߚߞⴕߦ✜৻ޕ‬ᶏᄖᣏⴕࠍᙘ߃ߡ޿ߥ޿ߎ ߣࠍਇᕁ⼏ߦᕁߞߚห௥ߩ൘߼ߢ ᐕ  ᦬ ߦㄭකࠍฃ⸻ߒߚ߇⇣Ᏹߪ⹺߼ࠄࠇߥ߆ߞߚ‫ޕ‬ห ᐕ  ᦬ߦᨱᄢቇ∛㒮‛ᔓࠇᄖ᧪ࠍฃ⸻ߒ㧘 ᦬ߦ ⣖ᵄߩ⇣Ᏹࠍᜰ៰ߐࠇߚ߇⚻ㆊࠍߺࠆߦߣߤ߹ߞ ߚ‫ߩߘޕ‬ᓟ ᐕ  ᦬ߦᤘ๺ᄢሼ␹⚻ౝ⑼ߩ ૬⸻ࠍ㐿ᆎߒߚ‫ ޕ‬ᐕ  ᦬ߦೋ߼ߡᄢ⊒૞߇

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࿑  MRITᒝ⺞↹௝  ฝየ⁁ᩭߦ㜞ାภၞࠍ⹺߼ࠆ߶߆ߪ᣿ࠄ߆ߥ⇣Ᏹߪ⹺߼ߥ޿

⴫  ᦯⮎೨ߩ␹⚻ᔃℂቇ⊛ᬌᩏ⚿ᨐ WAISRᚑੱ⍮⢻ᬌᩏ    VIQ      PIQ   FSIQ   Raven⦡ᓀࡑ࠻࡝࠶ࠢࠬ WMSR⸥ᙘᬌᩏ ⸒⺆ᕈ⸥ᙘ     ⷞⷡᕈ⸥ᙘ    ৻⥸⊛⸥ᙘ    ᵈᗧ㧛㓸ਛ ㆃᑧౣ↢ ਃቛᑼ⸥㌏ജᬌᩏ    ᦭㑐ଥኻ        ή㑐ଥኻ Benton ⷞⷡ⸥㌏ജᬌᩏ    ᱜ⏕ᢙ ⺋⻪ᢙ ㆙㓒⸥ᙘᬌᩏ  ᱦઍᐔဋrSD     ᐕઍ     ᐕઍ     ᐕઍ     ᐕઍ

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⥄Ꮖᢿ⮎ߒߚ‫ޕ‬એ㒠ߪ㧘ᤘ๺ᄢቇߩߺㅢ㒮ࠍ⛯ߌ ߚ߇᦯⮎ᜎุߩ⁁ᘒߪᄌࠊࠄߥ߆ߞߚ‫ߩߘޕ‬ᓟ㧘 ⺑ᓧߦࠃࠅࠞ࡞ࡃࡑ࠯ࡇࡦߩ᦯⮎ࠍ㐿ᆎߒߚ߇㧘 ᛩਈ⋥ᓟߦ⊒ᾲߒߚߚ߼ߺߕ߆ࠄਛᢿ㧘ⴊᶧᬌᩏ ߦߡ⢄ᯏ⢻㓚ኂ߇⹺߼ࠄࠇߚߚ߼એ㒠ߪࡃ࡞ࡊࡠ ㉄࠽࠻࡝࠙ࡓࠍᛩਈߒߚ‫߮ߚޕ‬㊀ߥࠆ⺑ᓧߦࠃࠅ ᦯⮎ࠍᛚ⻌ߔࠆߎߣ߽޽ߞߚ߇⛮⛯ߔࠆߎߣߪߥ ߆ߞߚ‫  ߪߩߚࠇߐ⹺⏕߇⮎᦯ߥ⊛⛯⛮ޕ‬ᐕ  ᦬‫ ޕ‬ᐕ  ᦬ߦ᦭ലᴦ≮ၞߦ㆐ߒߚ‫ޕ‬  ␹⚻ቇ⊛ᚲ⷗㧦⣖␹⚻♽࡮ㆇേ♽࡮ᗵⷡ♽ߦ⇣ Ᏹߪ⹺߼ߥ޿‫ޕ‬  ↹ ௝ᚲ⷗㧦↹௝ᚲ⷗ߢߪMRIT  ᒝ⺞↹௝

࿑ ߦߡฝየ⁁ᩭߦ㜞ାภၞࠍ⹺߼ࠆ߶߆ߪ SPECT ߣ߽ߦ᣿ࠄ߆ߥ⇣Ᏹߪ⹺߼ߥ޿‫ޕ‬  ⣖ᵄᚲ⷗㧦⣖ᵄߢߪ⊒૞㑆ᰳᤨߦਔ஥ߩ೨㗡㗡 㗂ㇱߦ᫚ᵄࠍ⹺߼ߚ‫ޕ‬෺ᭂሶㅊ〔ᴺߦߡὶὐࠍផ ቯߒߚ⚿ᨐ㧘Ꮐ஥㗡⪲ߩ೨ㇱߦ⊒૞ߩὶὐ߇หቯ ߐࠇߚ‫ޕ‬  ␹⚻ᔃℂቇ⊛ᚲ⷗㧦⛮⛯⊛ߥ᦯⮎㐿ᆎએ೨ߩ␹ ⚻ᔃℂቇ⊛ᬌᩏߩ⚿ᨐࠍ⴫  ߦ␜ߔ‫ޕ‬WAISR ᚑੱ⍮⢻ᬌᩏߢߪ㧘⸒⺆ᕈ㧘േ૞ᕈߣ߽ߦ⍮⢻ߪ ⦟ᅢߢ޽ࠅWMSR ⸥ᙘᬌᩏ㧘ਃቛᑼ⸥㌏ജ ᬌᩏ㧘Benton ⷞⷡ⸥㌏ജᬌᩏߥߤߩ೨ะᕈߩ⸥





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ᙘᬌᩏߢ߽ᐔဋ߽ߒߊߪᐔဋએ਄ߩᚑ❣ࠍ␜ߒ ߚ‫ޕ‬㆙㓒⸥ᙘᬌᩏߢߪ㧔ᷓᵤࠄ ૞ᚑߐࠇ ߚᤨᦼ߇ฎ޿ߚ߼⋥ធߩᲧセߪ࿎㔍ߢ޽ࠆ߇㧘 㨪 ᐕઍߩᚑ❣ૐਅ߇␜ໂߐࠇߚ‫ޕ‬        ++ஜᔓ∝⁁ߩ․ᓽ   ᧄ∝଀ߪ਄⸥ߩࠃ߁ߦ⸥㌏ജᬌᩏߢߪ᣿ࠄ߆ߥ 㓚ኂࠍ⹺߼ߥ޿ߦ߽߆߆ࠊࠄߕ㧘ᣣᏱ႐㕙ߢߪ㕖 ౖဳ⊛ߥએਅߩஜᔓ∝⁁߇⹺߼ࠄࠇߚ‫ޕ‬  ⊒૞ᤨߦ⹺߼ࠄࠇߚஜᔓ㧦ߣ߈ߦ㧘ᢙಽ㨪ᢙᤨ 㑆೨ߩߎߣࠍᙘ߃ߡ޿ߥ޿⁁ᘒ߇⹺߼ࠄࠇߚ‫ޕ‬એ ਅߪ  ᐕ  ᦬ߦ╩⠪ࠄ߇⋡᠄ߒߚ∝⁁ߢ޽ ࠆ‫ޕ‬  ᖚ⠪ߪᄖ᧪ᓙวቶߩ᫹ሶߦᐳࠅߥ߇ࠄ╩⠪ߦኻ ߒߡ೨ᣣߩ಴᧪੐ࠍ⹤ߒߡ޿ߚ߇㧘ᕆߦ㕒߆ߦ ߥߞߚ߆ߣᕁ߁ߣਔᚻࠍߔࠅวࠊߖ㧘ญࠍࡕࠧࡕ ࠧߣേ߆ߒᆎ߼ߚ‫ ⚂ޕ‬㨪 ಽߢญㇱ⥄േ∝ߪ෼ ߹ߞߚ߇㧘ᖚ⠪ߪ⸻ኤቶ߆ࠄ೨ߩੱ߇಴ߡߊࠆߩ ࠍ⷗ࠆߣ㧘૗ߏߣ߽ߥ߆ߞߚ߆ߩࠃ߁ߦή⸒ߩ߹ ߹⥄ಽߢ࠼ࠕࠍ㐿ߌ⸻ኤቶߦ౉ࠅਣ᫹ሶߦ⣶ដߌ ߡ⸻ኤࠍฃߌࠃ߁ߣߒߚ‫ޕ‬ਥᴦකߩ⾰໧ߦኻߒߡ 㨬ࡂࠗ㧘ࠗࠗࠛ‫ߣޠ‬㄰╵ߔࠆߎߣ߽น⢻ߢ޽ߞߚ‫ޕ‬ ߒ߆ߒ⹤߇߆ߺวࠊߥ޿߹߹ 㨪 ಽ߇⚻ㆊߒߚ‫ޕ‬ ߔࠆߣߦࠊ߆ߦ⴫ᖱ߇ᄌࠊࠅ㧘ળ⹤߽߆ߺว߁ࠃ ߁ߦߥߞߚ‫ߒ߆ߒޕ‬㧘ߎߩᤨὐߢߎࠇ߹ߢߩߎߣ ࠍ዆ߨࠆߣ㧘⸻ኤቶߦ౉ߞߡ߆ࠄߩߎߣߛߌߢߪ ߥߊ㧘⸻ኤ೨ߦᓙวቶߢળ⹤ߒߚߎߣ߽߹ߞߚߊ ᙘ߃ߡ޿ߥ߆ߞߚ‫╩ޕ‬⠪ࠄ߇ᖚ⠪߆ࠄ⡞޿ߚ೨ᣣ ߩ⹤ࠍᆎ߼ࠆߣ‫ࠍߣߎߥࠎߘߢࠎߥޟ‬⍮ߞߡ޿ࠆ ࠎߢߔ߆‫ߣޠ‬ਇᕁ⼏߇ߞߡ޿ߚ߶ߤߢ޽ࠆ‫ޕ‬ኅᣖ ߩ⹤ߢߪ㧘ߎߩࠃ߁ߦ⸥ᙘ߇ㅜ⛘߃ࠆ∝⁁߇᦬ߦ 㨪 ᐲߩ㗫ᐲߢ⹺߼ࠄࠇߚߘ߁ߢ޽ࠆ‫ޕ‬  㐳ᦼ⊛ߥ଻ᜬߩ㓚ኂ㧦ᧄ∝଀ߩ  ߟ߼ߩ․ᓽ ߪ㧘৻ᐲᙘ߃ߚߎߣࠍ㧘ᢙㅳ㑆ᓟߦߪᙘ߃ߡ޿ߥ ޿ߣ޿߁∝⁁ߢ޽ࠆ‫ߣ߽ߩ⸃ੌߩੱᧄޕ‬ᚻᏭࠍ⷗ ߖߡ߽ࠄ޿㧘 ᣣ೨ߦ⸥タߐࠇߡ޿ߚࡐࡇ࡯࿦ߩ ߎߣࠍ዆ߨࠆߣ㧘ⴕߞߚߎߣࠍ⹺߼ࠆߛߌߢߪߥ ߊ㧘ࡐࡇ࡯࿦߇ߤߩࠃ߁ߥ႐ᚲߦ޽ࠅ㧘⺕ߣⴕߞ ߚ߆ߥߤ㧘ߘߩᤨߩ⁁ᴫࠍ⹦⚦ߦㅀߴࠆߎߣ߇น ⢻ߢ޽ߞߚ‫ߒ߆ߒޕ‬㧘 ㅳ㑆ᓟߦหߓࠃ߁ߥ⾰໧ ࠍߔࠆߣ‫࡯ࡋޟ‬㧘ߘࠎߥߎߣ߇޽ߞߚࠎߢߔ߆‫ޠ‬ ߣߘߩᤨߩౝኈࠍᕁ޿಴ߔߎߣ߇ߢ߈ߥ߆ߞߚߛ 



ߌߢߪߥߊ㧘ߘߩ಴᧪੐ߦኻߔࠆᣢ⍮ᗵ߽␜ߔߎ ߣߪߥ߆ߞߚ‫ޕ‬  㐳ᦼߦࠊߚࠆㅒะᕈஜᔓ㧦 ߟ߼ߩ․ᓽߪ  ᐕએ਄ߦࠊߚࠆㅒะᕈஜᔓ߇⹺߼ࠄࠇߚὐߢ޽ࠆ

એਅ  ᐕ  ᦬ࠍၮὐߣߒߚ㧕 ‫ޕ‬   ᐕ೨  ᐕ  ᦬㧕ߦ㧘ᴒ✽⋵ߩ㔌ፉߦ  ੱߢᣏⴕߦⴕߞߚ߇㧘ߘߩߎߣࠍ዆ߨࠆߣ㧘ⴕߞ ߚߎߣߪ⹺߼ࠆ߇⚦ㇱࠍᕁ޿಴ߔߎߣߪߢ߈ߥ ߆ߞߚ‫ޕ‬หߓߊ  ᐕ೨  ᐕ  ᦬㧕ߦߪ෹ੱ ߣ᰷Ꮊᣏⴕߦⴕߞߡ޿ࠆ߇㧘ߘߩߎߣࠍ዆ߨߡ߽ ߹ߞߚߊᙘ߃ߡ޿ߥ߆ߞߚ‫ ޕ‬ᐕ೨  ᐕ  ᦬㧕ߦ޽ߞߚ࿾ਅ㋕ࠨ࡝ࡦ੐ઙߦߟ޿ߡ዆ߨࠆ ߣ㧘‫ޟ‬㤗ේ߇㑐ଥߒ㧘ࠨ࡝ࡦߦ߹ߟࠊࠆ‫ߣޠ‬੐ታ ࠍㅀߴࠆߎߣߪน⢻ߢ޽ߞߚ߇㧘⥄ಽ߇૶߁㚞๟ ㄝߢ⿠߈ߚ੐ઙߢ޽ࠆߦ߽߆߆ࠊࠄߕ㧘ߘߩᤨߩ ⁁ᴫߦ㑐ߒߡߪ㧘‫ߦߊߣޟ‬ᙘ߃߇ߥ޿‫ࠆ߃╵ߣޠ‬ ߩߺߢ޽ߞߚ‫ ޕ‬ᐕ೨  ᐕ  ᦬㧕ߦߪኅᣖ ✚಴ߢᣣశߦⴕ߈㧘޿ߊߟ߆ߩශ⽎⊛ߥࠕࠢࠪ࠺ ࡦ࠻ߦ⷗⥰ࠊࠇߚߦ߽߆߆ࠊࠄߕ㧘ᣏⴕߦⴕߞߚ ߎߣ߿ߘߩᤨߩߎߣࠍᕁ޿಴ߔߎߣߪߥ߆ߞߚ‫ޕ‬ ৻ᣇ㧘 ᐕ೨  ᐕ  ᦬㧕ߦ޽ߞߚ᧲੩ࠝ࡝ ࡦࡇ࠶ࠢߦߟ޿ߡ዆ߨࠆߣ㧘‫ޟ‬ਛቇᩞߩᤨߦ㆙⿷ ߩࠃ߁ߦߒߡ⷗ߦⴕ߈㧘࡟ࠬ࡝ࡦࠣࠍ⷗߹ߒߚ‫ޠ‬ ߣ⥄りߩ૕㛎ߣߒߡ⺆ࠆߎߣ߇น⢻ߢ޽ߞߚ‫ߎޕ‬ ߩࠃ߁ߦᧄ∝଀ߪ㐳ᦼߦࠊߚࠆㅒะᕈஜᔓ߇᣿ࠄ ߆ߢ޽ߞߚ‫ޕ‬  ᧄ∝଀ߢ⹺߼ࠄࠇߚஜᔓ∝⁁ࠍ߹ߣ߼ࠆߣᰴߩ ࠃ߁ߦߥࠆ‫⊒ޕ‬૞߇޽ࠆߣ⊒૞ਛߩ⸥ᙘߛߌ ߢߪߥߊ㧘⊒૞⋥೨ߩ⸥ᙘ߽ㅒะ⊛ߦ㓚ኂߐࠇ ߚ‫ޕ‬೨ะᕈߩ⸥ᙘߪ㧘㨪 ㅳ㑆ߩන૏ߢߪ଻ ߚࠇߡ޿ࠆ߇㧘 ㅳ㑆એ਄ߢߪ᣿ࠄ߆ߥૐਅ߇⹺ ߼ࠄࠇߚ‫ޕ‬ㅒะᕈߩ⸥ᙘߪ㧘ఽ┬ᦼ࡮㕍ᐕᦼ ߹ߢߪ⦟ᅢߢ޽ࠆ߇㧘ᚑੱᦼએ㒠ߦߥࠆߣ㗼⪺ߥ ૐਅࠍ⹺߼ߚ㧔ㅒะᕈஜᔓߩᦼ㑆ߪ  ᐕએ਄ߦ ߅ࠃࠎߢ޿ࠆߣᕁࠊࠇࠆ㧕‫ޕ‬       +++᦯⮎ᓟߩஜᔓ∝⁁

  ᦯⮎㐿ᆎ߹ߢߩ⚻ㆊ㧦ᧄ∝଀ߩ․ᓽߩ  ߟߣߒ ߡ㧘᦯⮎߇㕖Ᏹߦ࿎㔍ߢ޽ߞߚߎߣ߇޽ߍࠄࠇ ࠆ‫ޕ‬Benson ߪ㧘ߡࠎ߆ࠎߦ઻߁ᕈᩰᄌ ൻࠍ Geschwind ∝୥⟲ߣߒߡ߹ߣ߼㧘ߘߩ․ᓽ ߣߒߡ㧘ᦠሼㆊᄙߦઍ⴫ߐࠇࠆࠃ߁ߥㄤ㆙ 



㜞ᰴ⣖ᯏ⢻⎇ⓥ ╙  Ꮞ╙  ภ

 

࿑  ᦯⮎೨ᓟߩ␹⚻ᔃℂቇ⊛ᬌᩏ⚿ᨐߩᲧセ  WAISR ߢߪ᣿ࠄ߆ߥᄌൻࠍ⹺߼ߥ޿߇㧘WMSR ߢ㗼⪺ߥᡷༀ߇⹺߼ࠄࠇߚ‫ߦߊߣޕ‬ㆃᑧౣ↢ ߩᡷༀ߇⪺ߒߊ㧘 ࡐࠗࡦ࠻એ਄ߩᄌൻ߇⹺߼ࠄࠇߚ‫ޕ‬

ᕈ㧘ᕈ⊛㑐ᔃߩૐਅ㧘ቬᢎ߿ືቇ⊛ߥߎ ߣ߳ߩ㑐ᔃߩᷓ߹ࠅࠍ޽ߍߡ޿ࠆ‫߽଀∝ᧄޕ‬ Geschwind ∝୥⟲ߣߒߡߣࠄ߃ࠆߎߣ߇น⢻ߥ ޿ߊߟ߆ߩ․ᓽ߇⹺߼ࠄࠇߚ‫ޕ‬   ߟߪᦠሼㆊᄙߢ޽ࠆ‫ޕ‬ᚻᏭߦߪዊߐߥᰣࠍ ૶ߞߡᣣ⸥ߩࠃ߁ߦߘߩᣣߩ಴᧪੐߇㕖Ᏹߦస᣿ ߦ⸥タߐࠇߡ޿ߚ‫ߚ߹ޕ‬㧘⥄ਥ⊛ߦߟߌߡ޿ߚ∛ ⁁ᣣ⸥ߦߪ㧘ᄢቇࡁ࡯࠻ᢙࡍ࡯ࠫߦࠊߚߞߡ㧘৻ ⷗㧘ขࠅߣ߼߽ߥ޿ࠃ߁ߥᢥ┨߿∝⁁߇⸥タߐࠇ ߡ޿ࠆߎߣ߽޽ߞߚ‫ޕ‬  ߽߁  ߟߩ․ᓽߪ㧘㕖Ᏹߦᒝ޿ቬᢎ᭽ߩାᔨߢ ޽ࠆ‫ߪ଀∝ᧄޕ‬㧘޽ࠆᤨᦼ߆ࠄቬᢎ⊛ߥ⦡ᓀߩᒝ ޿࡛ࠟߦ௑ୟߒᆎ߼㧘ߘߩਥቿ⠪ߩᓇ㗀ߢ㧘‫ޟ‬㧔ߡ ࠎ߆ࠎ⊒૞߽฽߼ߡ㧕૕߆ࠄ಴ߡߊࠆ߽ߩߦߪߔ ߴߡᗧ๧߇޽ࠆ‫ࠍࠇߘޕ‬ήℂߦ᛼ߐ߃ㄟࠎߢߒ߹ ߁ߩߪࠃߊߥ޿‫ޠ‬ 㧘‫ޟ‬૕ߦߪ⥄ὼᴦ≹ജ߇஻ࠊߞߡ ޿ࠆߩߢ⮎ߦ㗬ࠆᔅⷐߪߥ޿‫߁޿ߣޠ‬ᒝ޿ାᔨࠍ ᜬߟߦ޿ߚߞߚ‫ߥ߁ࠃߩߎޕ‬ᒝ޿ାᔨ߇㧘㐳ᦼߦ ࠊߚߞߡ᦯⮎ࠍᜎߺ⛯ߌࠆ৻࿃ߣߥߞߚ‫ޕ‬  ᦯⮎ߩ⛮⛯߇࿎㔍ߥ߽߁  ߟߩℂ↱ߪ㧘⸥ᙘ㓚 ኂߦࠃࠆ߽ߩߢ޽ߞߚ‫ߜࠊߥߔޕ‬㧘᧪㒮ߒߚᤨߦ ߪ⮎ࠍ㘶߻ߎߣߦ⚊ᓧߒߡ߽㧘ߘߩ⁁ᘒ߇ᜬ⛯ߖ ߕ㧘ᢙᣣᓟߦߪ᦯⮎ࠍ⥄ಽ߆ࠄਛᱛߒ㧘ᰴߩ᧪㒮 ᤨߦߪ㧘ቬᢎ᭽ߩାᔨߦࠃࠆ᦯⮎ᜎุߣ޿߁⁁ᘒ ߇➅ࠅ㄰ߐࠇߚ‫ ߼ߚߩߘޕ‬ᐕ  ᦬ߏࠈࠃ ࠅ㧘ᧄੱߩੌ⸃ߩ߽ߣ㧘ᢙᣣߏߣߦ╩⠪߇ᖚ⠪ቛ

ߦ㔚⹤ࠍߒ㧘᦯⮎ߩ⏕⹺ࠍⴕߞߚ‫ߩߘޕ‬ᓟ㧘 ᐕߩ  ᦬ࠃࠅ߶߷⛮⛯⊛ߥ᦯⮎߇⏕⹺ߐࠇ㧘 ᐕ  ᦬ߦ᦭ലᴦ≮ၞߦ㆐ߒߚ‫ޕ‬  ኅᣖߦࠃࠆߣ᦯⮎ᓟߦ߽ߞߣ߽ᄢ߈ߊᄌൻߒߚ ὐߪ㧘ᕈᩰᄌൻߛߘ߁ߢ޽ࠆ‫ޕ‬એ೨ߪ㧘㗎࿕ߢઁ ੱߩ⹤ࠍ߹ߞߚߊ⡞߈౉ࠇࠃ߁ߣߒߥ߆ߞߚ߇㧘 ᦨㄭߪ㧘‫ޟ‬ᤄ㧔ߩᧄੱ㧕ߦᚯߞߚࠃ߁ߛ‫ߣޠ‬ㅀߴ ߡ޿ࠆ‫ߚ߹ޕ‬㧘એ೨ߢ޽ࠇ߫᧪㒮ߔࠆߚ߮ߦ╩⠪ ࠄߦኻߒߡቬᢎ⊛ߥ⹤ࠍߔࠆߎߣ߇ᄙ߆ߞߚ߇㧘 ᦯⮎એ㒠⹺߼ߥߊߥߞߚ‫ޕ‬  ஜᔓ∝⁁ߣ⊒૞ߩ㗫ᐲ㧦⛮⛯⊛ߥ᦯⮎߇㐿ᆎߐ ࠇߚᓟ߽ᄢ⊒૞ࠍ  ᐲ⿠ߎߒߡ޿ࠆ߇㧘᦭ലᴦ≮ ၞߦ㆐ߒߚ  ᐕ  ᦬એ㒠ߪ⹺߼ߡ޿ߥ޿‫ޕ‬ዊ ⊒૞ߪኅᣖ߇⏕⹺ߢ߈ࠆ▸࿐ߢߪᷫዋߒߡ޿ࠆ ߇㧘ቢోߦߪᶖᄬߖߕ㧘ᤨᦼߦࠃߞߡ᏷߇޽ࠅ㧘 ዋߥ޿ᤨߦߪ  ࿁᦬㧘ᄙ޿ᤨߦߪ  ࿁᦬㧘ኅᣖ ߦ⋡᠄ߐࠇߡ޿ࠆ‫ޕ‬  ⊒૞ߩ᦭ήߣஜᔓ∝⁁ߣߩ㑐ㅪߪቯ㊂⊛ߦߪ᣿ ࠄ߆ߢߪߥ޿߇㧘ߘߩ㑐ㅪᕈ߇␜ໂߐࠇߚ‫ޕ‬ ᐕ 㨪 ᦬ߩ㑆ߦ  ࿁ߦࠊߚߞߡዊ⊒૞߇⏕⹺ߐ ࠇߡ޿ࠆ߇㧘 ᦬ߩ᧪㒮ᤨߦߪ  ᦬ߩ᧪㒮ᤨߩߎ ߣࠍ߶ߣࠎߤᙘ߃ߡ޿ߥ߆ߞߚ‫৻ޕ‬ᣇ㧘㨪 ᦬ ߩ㑆ߦߪ⊒૞ߪ⏕⹺ߐࠇߕ㧘 ᦬ߩ᧪㒮ᤨߦߪ  ᦬ߦ⹤ߒߚౝኈࠍᙘ߃ߡ޿ߚߛߌߢߪߥߊ㧘⚂᧤ ߒߚߎߣࠍ⺋ࠅߥߊታⴕߔࠆߎߣ߇น⢻ߢ޽ߞ ߚ‫ޕ‬



 ᐕ  ᦬ ᣣ



࿑  ᦯⮎ᓟߩ⿥㐳ᦼ⊛ߥ೨ะᕈஜᔓ    ᐕ  ᦬㧔⛮⛯⊛ߥ᦯⮎㐿ᆎ߆ࠄ  ࡨ᦬ᓟ㧕ߩᤨὐࠍၮὐߣߒߡ㧘ᚻᏭ ߦ⸥タߐࠇߡ޿ࠆߎߣࠍ߽ߣߦㅒะ⊛ߦ಴᧪੐ߩ⸥ᙘࠍ⏕⹺ߒߚ‫⮎᦯߷߶ޕ‬ ߇⏕⹺ߐࠇߚᤨὐࠍႺߦ㧘ౣ↢น⢻ߥ㗄⋡߇ㅪ⛯ߔࠆߎߣ߇᣿ࠄ߆ߦߥߞߚ‫ޕ‬

࿑  ᦯⮎೨ᓟߩ⿥㐳ᦼ⊛ߥ೨ะᕈஜᔓߩᲧセ  ᬌᩏࠍታᣉߒߚᤨὐࠍၮḰߦߘࠇߙࠇ⋧ኻ⊛ߥ᦬ᢙߢ⴫ߒߡ޽ࠆ‫⮎᦯ޕ‬㐿 ᆎ೨  ᐕ  ᦬㧕ߢߪ 㨪 ࡨ᦬೨ߩ಴᧪੐ߦߥࠆߣౣ↢ߔࠆߎߣ߇࿎㔍 ߢ޽ߞߚ߇㧘⛮⛯⊛ߥ᦯⮎߇⏕⹺ߐࠇߚᓟ  ᐕ  ᦬㧕ߢߪ  ࡨ᦬೨ߩߎ ߣ߽ౣ↢น⢻ߢ޽ߞߚ‫ ߦࠄߐޕ‬ᐕ  ᦬ߩᤨὐߢߪ㧘⚂  ᐕ೨ߩߎߣ߽ ⹦⚦ߦᕁ޿಴ߔߎߣ߇น⢻ߢ޽ߞߚ‫ޕ‬

 ᦯⮎೨ᓟߩஜᔓ∝⁁㧦᦯⮎೨ᓟߩ␹⚻ᔃℂቇ⊛

ᬌᩏ⚿ᨐߩᲧセࠍ࿑  ߦ␜ߔ‫ޕ‬WAISR ߢߪ᣿ ࠄ߆ߥᄌൻࠍ⹺߼ߥ޿߇WMSR ߢ㗼⪺ߥᡷ ༀ߇⹺߼ࠄࠇߚ‫ߦߊߣޕ‬ㆃᑧౣ↢ߩᡷༀ߇⪺ߒ ߊ㧘 ࡐࠗࡦ࠻એ਄ߩᄌൻ߇⹺߼ࠄࠇߚ‫ޕ‬  ೨ะᕈஜᔓߦߟ޿ߡߩᄌൻࠍ࿑  ߦ␜ߔ‫ޕ‬

ᐕ  ᦬㧔⛮⛯⊛ߥ᦯⮎㐿ᆎ߆ࠄ  ࡨ᦬ᓟ㧕ߩᤨ ὐࠍၮὐߣߒߡ㧘ᚻᏭߦ⸥タߐࠇߡ޿ࠆߎߣࠍ߽ ߣߦㅒะ⊛ߦ಴᧪੐ߩ⸥ᙘࠍ⏕⹺ߒߚ‫⚿ߩߘޕ‬ ᨐ㧘߶߷᦯⮎߇⏕⹺ߐࠇߚᤨὐࠍႺߦ㧘ౣ↢น⢻ ߥ㗄⋡߇ㅪ⛯ߒߚ‫ޕ‬  ࿑  ߪ᦯⮎೨ᓟߢߩᲧセߢ޽ࠆ‫ࠇߙࠇߘޕ‬ᬌ⸛

  㜞ᰴ⣖ᯏ⢻⎇ⓥ ╙  Ꮞ╙  ภ

 

ߒߚᤨὐࠍၮὐߣߒߚ⋧ኻ⊛ߥ᦬ᢙߢ⴫ߒߡ޽ ࠆ‫⮎᦯ޕ‬㐿ᆎ೨ߢߪ 㨪 ࡨ᦬೨ߩ಴᧪੐ߦߥࠆ ߣౣ↢ߔࠆߎߣ߇࿎㔍ߢ޽ߞߚ߇㧘᦯⮎㐿ᆎᓟߢ ߪ  ࡨ᦬೨ߩߎߣ߽ౣ↢น⢻ߢ޽ߞߚ‫ߦࠄߐޕ‬  ᐕ  ᦬ߩᤨὐߢߪ㧘⚂  ᐕ೨ߩߎߣ߽⹦⚦ ߦᕁ޿಴ߔߎߣ߇น⢻ߢ޽ߞߚ‫ޕ‬  ৻ᣇ㧘ㅒะᕈߩ⸥ᙘߦߟ޿ߡߪ㗼⪺ߥᄌൻߪ⹺ ߼ࠄࠇߥ߆ߞߚ‫⮎᦯ޕ‬೨ߦౣ↢߇࿎㔍ߢ޽ߞߚ  ᐕએ਄ߦࠊߚࠆ಴᧪੐ߦ㑐ߒߡߪ᦯⮎ᓟ߽ห ᭽ߦౣ↢߇࿎㔍ߢ޽ߞߚ‫৻ޕ‬ᣇ㧘␠ળ⊛ߥ಴᧪੐ ߦ㑐ߔࠆ㆙㓒⸥ᙘᬌᩏߢߪ㧘߽ߞߣ߽⥋ㄭߥ  ᐕઍߩߺ⧯ᐓߩᄌൻ 㧑ψ㧑㧕߇⹺߼ࠄࠇ ߚ‫ޕ‬          +8⠨  ኤ



 ᧄ∝଀ߩஜᔓ∝⁁ߩ․ᓽߪએਅߩὐߢ޽ߞߚ‫ޕ‬  ೨ะᕈஜᔓߪ㧘ᢙᤨ㑆߿ᢙᣣߩන૏ߢߪ᣿ࠄ߆ ߢߪߥߊ㧘ᢙㅳ㑆㧔ዋߥߊߣ߽  ㅳ㑆㧕ᓟߦߥߞ ߡೋ߼ߡ㗼࿷ൻߒߚ‫৻ޕ‬ᣇ㧘⊒૞ᤨߦߪ⊒૞ਛߛ ߌߢߪߥߊ㧘⊒૞೨ߩ⸥ᙘ߽㓚ኂߐࠇߚ‫ߩ∝⊒ޕ‬ ᤨὐߪ᣿⏕ߢߪߥ޿߇㧘ㅒะᕈஜᔓߪ  ᐕએ਄ ߦࠊߚࠆ߽ߩߢ޽ߞߚ‫ޕ‬  ⛮⛯⊛ߥ᦯⮎߇⏕⹺ߐࠇࠆࠃ߁ߦߥߞߡ߆ࠄ ߪ㧘⊒૞߇ᛥ೙ߐࠇߡ޿ࠆ߆߉ࠅ೨ะᕈஜᔓߩᡷ ༀ߇⹺߼ࠄࠇߚ߇㧘ㅒะᕈஜᔓߩᄌൻߪ᣿ࠄ߆ߢ ߪߥ߆ߞߚ‫ޕ‬  ߡࠎ߆ࠎ⊒૞ߦ⿠࿃ߔࠆ⸥ᙘ㓚ኂ଀㧦Kapur ࠄ㧔㧕ߪ㧘ߡࠎ߆ࠎ⊒૞ߦ⿠࿃ߔࠆ⸥ᙘ㓚ኂ ࠍᢛℂߒ㧘ߘߩ∛ᘒࠍએਅߩ  ⒳㘃ߦಽ㘃ߒߡ޿ ࠆ‫৻ޕ‬ㆊᕈߡࠎ߆ࠎᕈஜᔓ transient epileptic amnesia㧦⸥ᙘ㓚ኂࠍਥ૕ߣߔࠆߡࠎ߆ ࠎ⊒૞ߢ޽ࠆ‫⿥ޕ‬㐳ᦼ⊛ߥ೨ะᕈஜᔓ very longterm amnesia㧦৻ቯߩᦼ㑆ࠍ޽ߌߡ⹏ଔ ߔࠆߎߣߦࠃߞߡೋ߼ߡ᣿ࠄ߆ߦߥࠆஜᔓߢ޽ ࠆ‫ࠅ➅ޕ‬㄰ߐࠇࠆ⊒૞߇㐳ᦼ⸥ᙘߩ࿕ቯൻࠍ㒖ኂ ߔࠆߚ߼ߦ↢ߓࠆߣ⠨߃ࠄࠇߡ޿ࠆ‫ޕ‬㒢ዪᕈ ὶὐᕈㅒะᕈஜᔓ circumscribed focal retrograde amnesia㧦೨ะᕈஜᔓࠍ઻ࠊߕ㧘⊒∝೨ ߩߏߊ⍴ᦼ㑆ߦ㒢ࠄࠇߚㅒะᕈஜᔓߢ޽ࠆ‫⊒ޕ‬૞ ߇࿕ቯൻࠍ৻ᤨ⊛ߦ㒖ኂߔࠆߚ߼㧘࿕ቯൻߩㅜਛ ߩ⸥ᙘ߇ㅒะᕈஜᔓߩᒻߢ↢ߓࠆߣ⠨߃ࠄࠇߡ޿ ࠆ‫ޕ‬

 ߹ߚ㧘⊒૞ߦ઻ߞߡ⸥ᙘ߇㓚ኂߐࠇࠆ∛ᘒߣߒ ߡ㧘਄⸥ߩ Kapur ࠄ ߩ৻ㆊᕈߡࠎ߆ࠎ ᕈஜᔓએᄖߦ㧘⚐☴ஜᔓ⊒૞ pure amnesic seizure߿⊒૞ᓟஜᔓ⁁ᘒ postictal amnesic state Palmini ࠄ 㧘੗਄ࠄ ߇⍮ࠄ ࠇߡ޿ࠆ‫☴⚐ޕ‬ஜᔓ⊒૞ߪ㧘৻ㆊᕈߡࠎ߆ࠎᕈஜ ᔓߦ㘃ૃߒߚ∛ᘒߢ޽ࠆ߇㧘⊒૞ᓟஜᔓ⁁ᘒߪ㧘 ⊒૞ਛߛߌߢߪߥߊ⊒૞೨ߩߎߣ߽ᙘ߃ߡ޿ߥ޿ ὐ߇․ᓽ⊛ߢ޽ࠆ‫ޕ‬  ߹ߚ㧘ߡࠎ߆ࠎ⊒૞ߦ㑐ㅪߒߚㅒะᕈஜᔓߦߟ ޿ߡߪ㧘Kapur ࠄ㧔㧕ߩࠃ߁ߥ㒢ዪߐࠇߚ ㅒะᕈஜᔓߛߌߢߪߥߊ㧘ᢙචᐕߣ޿߁න૏ߢࠃ ࠅ㐳ᦼߦ߅ࠃ߱ߎߣ߽␜ໂߐࠇߡ߅ࠅ Manes ࠄ ⊒૞߇࿕ቯൻߩ㓚ኂߛߌߢߪߥߊ㧘⊹ ⾰ߦ޽ࠆߣߐࠇߡ޿ࠆ⸥ᙘ∥〔ߩᶖᄬ߽ᒁ߈⿠ߎ ߔߣ⠨߃ࠄࠇߡ޿ࠆ‫ޕ‬  ᧄ∝଀ߩஜᔓ∝⁁ߣߡࠎ߆ࠎ⊒૞㧦ᧄ∝଀ߩ  ߟ߼ߩ․ᓽߪ㧘⊒૞ਛߛߌߢߪߥߊ⊒૞ߩᢙಽ 㨪ᢙᤨ㑆೨ߩߎߣ߽ᙘ߃ߡ޿ߥ߆ߞߚὐߢ޽ࠆ‫ޕ‬ ߎࠇߪ㧘⸻ኤቶߩᚺࠍ㐿ߌߡਛߦ౉ࠅ⌕Ꮸߔࠆߥ ߤߩ৻ㅪߩ⥄ᓞ⊛ߥⴕേ߇น⢻ߢ޽ࠅ㧘⾰໧ߦኻ ߔࠆ෻ᔕᕈ߽଻ߚࠇߡ޿ߚߎߣ߆ࠄ㧘⊒૞ᓟ߽߁ ࠈ߁⁁ᘒߢߪߥߊKapur ࠄ㧔㧕ߩ৻ㆊᕈ ߡࠎ߆ࠎᕈஜᔓ㧘ߥ޿ߒߪⶄ㔀ㇱಽ⊒૞⋥ᓟߢ޽ ࠅPalmini ࠄ ߿੗਄ࠄ ߩ⸒߁ ⊒૞ᓟஜᔓ⁁ᘒߦㄭ޿∛ᘒߢ޽ߞߚߣ⠨߃ࠄࠇ ࠆ‫ޕ‬   ߟ߼ߩ․ᓽߪ㧘৻ᐲߪᙘ߃ߚߎߣࠍᢙㅳ㑆ᓟ ߦߪᙘ߃ߡ޿ߥ޿ߣ޿߁ὐߢ޽ߞߚ‫ߥ߁ࠃߩߎޕ‬ ೨ะᕈஜᔓߪ㧘ߡࠎ߆ࠎ⊒૞એᄖߢ߽↢ߓ߁ࠆߎ ߣ߇ႎ๔ߐࠇߡ޿ࠆ߇ Lucchelli ࠄ ᧄ ∝଀ߩ႐ว㧘᛫ߡࠎ߆ࠎ⮎ߦࠃߞߡ∝⁁ߩᡷༀ߇ ⹺߼ࠄࠇߚߎߣ߆ࠄ㧘ߡࠎ߆ࠎ⊒૞ߦࠃߞߡ࿕ቯ ൻ߇㒖ኂߐࠇߚ⚿ᨐ↢ߓߚ⿥㐳ᦼ⊛ߥ೨ะᕈஜᔓ ߢ޽ߞߚߣ⠨߃ࠄࠇࠆ‫ߚ߹ޕ‬㧘 ࡨ᦬㑆ߩ⊒૞ߩ 㗫ᐲߣ  ࡨ᦬೨ߩ⸥ᙘ㓚ኂߣߩ㑐ଥ߇␜ໂߐࠇߚ ߇㧘⊒૞ߩ㗫ᐲ߇ஜᔓߩ⒟ᐲߦ㑐ㅪߔࠆߣߔࠆႎ ๔߽޽ࠅ㧔O’Connor ࠄ ᧄ∝଀ߩ႐ว߽ ⊒૞ߩ㗫ᐲߩ㆑޿ߦࠃࠅ㧘࿑  ߩ᦯⮎೨ߩࠃ߁ߥ ߹ߛࠄ⁁ߩ⚿ᨐ߇↢ߓߚߩ߆߽ߒࠇߥ޿‫ޕ‬   ߟ߼ߩ․ᓽߪ  ᐕએ਄ߦࠊߚࠆㅒะᕈஜᔓ ߢ޽ߞߚ‫ߩ଀∝ᧄޕ‬ᱜ⏕ߥ⊒∝ᤨᦼߪਇ᣿ߢ޽ࠆ 





 ᐕ  ᦬  ᣣ

߇㧘ዋߥߊߣ߽ᕈᩰᄌൻ߿⸥ᙘߩ⇣Ᏹߦ᳇ߠ߆ࠇ ߚ  ᐕߏࠈߣ⠨߃ࠆߩ߇ᅷᒰ߆߽ߒࠇߥ޿‫ޕ‬ Kapur ࠄ㧔㧕ߩ㒢ዪᕈὶὐᕈㅒะᕈஜᔓߦ ࠃߞߡ↢ߓߚߣ⠨߃ࠆߎߣ߽น⢻ߢ޽ࠆ߇㧘ߎߩ 㗃ࠍၮὐߣߒߡ߽㓚ኂߐࠇߚᦼ㑆߇  ᐕએ਄ߦ ߅ࠃ߱㕖Ᏹߦ㐳ᦼߥ߽ߩߢ޽ࠆߎߣ߆ࠄ㧘ᧄ∝଀ ߩ႐วBlake ࠄ㧔㧕ߩ⸒߁⸥ᙘ∥〔ߩᶖᄬ ߣߣࠄ߃ࠆᣇ߇ᅷᒰ߆߽ߒࠇߥ޿‫ޕ‬  ᛫ߡࠎ߆ࠎ⮎ߩஜᔓ∝⁁߳ߩᓇ㗀㧦␹⚻ᔃℂቇ ⊛ᬌᩏߢߪWMSR ߩㆃᑧౣ↢ߢ㗼⪺ߥᚑ❣ ߩ਄᣹ࠍ⹺߼ߚ‫⮎᦯ޕ‬೨ߩㆃᑧౣ↢ߩᚑ❣ߪஜᏱ ⠪ߣᲧセߒߡ᣿ࠄ߆ߦૐ޿߽ߩߢߪߥ޿߇㧘᦯⮎ ߢᡷༀ߇⹺߼ࠄࠇߚߎߣ߆ࠄ߽㧘ߎߩࠃ߁ߥ  ಽߣ޿߁㑆㓒ߢߔߢߦ⊒૞ߩᓇ㗀߇޽ߞߚߩ߆߽ ߒࠇߥ޿‫ޕ‬  ೨ะᕈߩ⸥ᙘߪߎࠇએᄖߦ߽ᡷༀ߇᣿ࠄ߆ߢ㧘 ⿥㐳ᦼ⊛ߥ೨ะᕈஜᔓ߇↢ߓࠆ  ㅳ㑆એ਄ߦࠊ ߚߞߡ଻ᜬߐࠇࠆߎߣ߇⏕⹺ߐࠇߚ‫߁ࠃߩߎޕ‬ ߦ㧘⊒૞ߩ᦭ή߇⿥㐳ᦼ⊛ߥ೨ะᕈஜᔓߦᄌൻࠍ ߽ߚࠄߔߎߣ߇␜ߐࠇߚ‫ޕ‬  ৻ᣇ㧘ㅒะᕈஜᔓߦ㑐ߒߡߪ㧘ߘߩᦼ㑆߇⍴❗ ߒߚ੐ታߪ⃻ᤨὐߢߪ⏕⹺ߐࠇߥ߆ߞߚ‫ޕ‬ㅒะᕈ ஜᔓ߇㓚ኂߐࠇࠆㆊ⒟ߪ㕖นㅒ⊛ߥ߽ߩߢ޽ࠅ㧘 ৻ᐲߢ߽⸥ᙘ∥〔߿࿕ቯൻߩㆊ⒟߇ᓇ㗀ࠍฃߌߚ ႐วߦߪ㧘ᡷༀߔࠆߩߪ㔍ߒ޿ߩ߆߽ߒࠇߥ޿‫ޕ‬ 

߅ࠊࠅߦ   ߡࠎ߆ࠎ⊒૞ߦ⿠࿃ߔࠆߣ⠨߃ࠄࠇࠆஜᔓ∝଀ ࠍ๒␜ߒߚ‫ߦ߁ࠃߩߎޕ‬㧘ߡࠎ߆ࠎ⊒૞ߦ⿠࿃ߔ ࠆ⥃ᐥ∛ᘒࠍ᣿ࠄ߆ߦߔࠆߎߣߢ㧘ߡࠎ߆ࠎߣ⸥ ᙘߩ㑐ଥߛߌߢߪߥߊ㧘ੱ㑆߇ᜬߟ⸥ᙘߩ৻஥㕙 ߇᣿ࠄ߆ߦߥࠆน⢻ᕈࠍ⒁߼ߡ޿ࠆߣᕁࠊࠇࠆ‫ޕ‬ ੹ᓟߪ㧘ߡࠎ߆ࠎ⊒૞ߩὶὐࠍࠃࠅᱜ⏕ߥ♖ᐲߢ หቯߐߖࠆߎߣߦࠃࠅ㧘߹ߛ᣿ࠄ߆ߦߥߞߡ޿ߥ ޿∛Ꮍߣߩኻᔕ߇น⢻ߣߥࠆߩߢߪߥ޿ߛࠈ߁ ߆‫ޕ‬           ᢥ  ₂

 Benson, D.F.㧦The Geschwind syndrome. In㧦 Advances in Neurology, Vol.(eds Smith, D.,

  Treiman, D. & Trimble, M.). Raven Press,   New York, , pp.. Blake, R.V., Wroe, S.J., Breen, E.K., et al.㧦   Accelerated forgetting in patients with epi  lepsy㧦Evidence for an impairment in memory   consolidation. Brain, 㧦 ᷓᵤ⃍ሶ⮮੗ବൎ૒⮮⌬ሶ߶߆㧦㐳ᦼ⸥ᙘߦ   ኻߔࠆᐕ㦂ߩᓇ㗀㧚⥃ᐥ␹⚻ቇ㧘㧦    HughlingsJackson,J.㧦On a particular variety   of epilepsy 㧔“Intelectual Aura”), one case with   symptoms of organic brain disease. Brain, 㧦    ੗਄᦭ผᷡ㊁᣽৻ਃේᔘ⚔߶߆㧦஥㗡⪲ߡࠎ   ߆ࠎߦ߅ߌࠆஜᔓ⊒૞ߣ⊒૞ᓟஜᔓ⁁ᘒ̆ ∝   ଀ߩஜᔓ∝⁁࡮㗡⬄ౝ⣖ᵄߩಽᨆ̆㧚ߡࠎ߆ࠎ⎇   ⓥ㧘㧦  Kapur, N., Thompson, P., Evans, J., et al.㧦Can   epilepsyrelated phenomena unlock some of   the secrets of long term memory ? In㧦Fron  tiers of Human Memory eds Yamadori, A.,   Kawashima, R., Fujii, T., et al.. Tohoku Uni  versity Press, Sendai, pp.  Lucchelli, F. & Spinnler, H.㧦Ephemeral new   traces and evaporated remote engrams㧦A   form of neocortical temporal lobe amnesia ?   Neurocase, 㧦 Manes,F.,Hodges, J.R., Graham, K.S., et al.㧦   Focal autobiographical amnesia in association   with transient epileptic amnesia. Brain, 㧦   㧘 O’Connor, M., Sieggreen, M.A., Ahern,G., et   al.㧦Accelerated forgetting in association with   temporal lobe epilepsy and paraneoplastic   encephalitis. Brain Cogn., 㧦 Palmini,A.L., Gloor, P. & JonesGotman, M.㧦   Pure amnesic seizures in temporal lobe epi  lepsy. Brain, 㧦 Zeman,A.Z.J.,Boniface,S.F.& Hodges,J.R.㧦   Transient epileptic amnesia㧦A description of   the clinical and neuropsychological features in    cases and review of the literature. J. Neurol.   Neurosurg. Psychiatry, 㧦



㜞ᰴ⣖ᯏ⢻⎇ⓥ ╙  Ꮞ╙  ภ

 

‫ع‬Abstract

Epileptic amnesia

Akira Midorikawa㧖㧖㧖㧖㧖㧖Naoko Yoshimura㧖㧖 Mitsuru Kawamura㧖㧖㧖㧖㧖   We examined a patient with temporal lobe epilepsy, who presented unusual amnesic pattern

without memory impairment, which manifested in a regular examination. Her ictal state was characterized by amnesia with brief period of retrograde amnesia following complex partial seizure. Anterograde amnesia came out only after four weeks later. Retrograde memory especially autobiographical content was severely disturbed for over twenty years. We interpreted these phenomenons as a result of consolidation deficit of longterm memory and an erasure of memory engram, which represented in neocortex following repetitive seizures. After medication, her anterograde memory deficit recovered drastically㧧however, her retrograde amnesia did not improved. These results suggest that retrograde amnesia occurred as a nonreversible phenomenon. We think that the investigation of epilepsy and amnesia unlock the secret of memory function of human being.

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Department of Animal Models for Human Disease, National Institute of Neuroscience, NCNP. 411 OgawaHigashimachi,



Kodairashi, Tokyo Japan 㧖㧖

Department of Neurology, Showa University School of Medicine

㧖㧖㧖

Japan Science and Technology Agency